This proposal is consistent with the research priorities of RFA-OD-09-004 (RC2), "Expanding and Personalizing Treatment Options for Alcohol Disorders". At present, a wide gap exists between the number of individuals needing alcohol abuse treatment and the number actually receiving it. Many factors account for this gap, including treatment availability and affordability, individuals wanting to independently solve their problems with alcohol, and stigma associated with receiving treatment. Due to their potential to circumvent these treatment barriers, technological innovations hold promise for increasing dramatically the number of individuals who receive treatment services. For example, recent research has indicated that readily- accessible web-based alcohol interventions are effective in reducing alcohol consumption among problem drinkers. However, such web-based interventions are limited to the extent that they are not sensitive to, or available within, the everyday environment in which drinking or relapse occurs. This lack of immediacy is particularly a concern as research has demonstrated consistently that cues, such as locations where an individual has previously drank, are strong triggers for continued alcohol use or relapse and that these cues often overwhelm an individual's rational decision-making abilities. To address these concerns and to make interventions more readily available and accessible, one approach is to use emerging technologies to develop a tool that helps to intervene in actual high-risk locations. The primary aim of this project is to develop such a tool, the Location-Based Monitoring and Intervention - Alcohol (LBMI-A), a system that utilizes recent advances in GPS-enabled smartphones. The LBMI-A will be programmed to alert users when they are entering their geographically defined high-risk areas for relapse and provide an immediate psychosocial intervention (e.g., by sending a text message to a support person and providing coping strategies). Other LMBI-A features will include assessment and feedback reports, alcohol use self- monitoring and feedback functions, and skills modules (e.g., coping skills). During Phases I and II of the proposed project, the initial technological and psychosocial intervention aspects of the LBMI-A will be developed. In Phase III, alcoholism treatment experts will test and review the LBMI-A and modifications will be made based on their recommendations. In Phase IV, a 6-week, randomized waitlist control pilot study will be performed with 60 young adults who demonstrate mild to moderate alcohol dependence. User- interface data will be gathered to examine how the LBMI-A is used by this population and pilot data will be gathered to examine its efficacy as an intervention tool. In Phase V, based on pilot data, the LBMI-A will be finalized and prepared for additional, rigorous testing for efficacy in future research. PUBLIC HEALTH RELEVANCE: Alcohol abuse and alcoholism are serious public health issues that have significant individual and society costs. It is estimated that over 80% of people who need alcohol treatment are unable to access it due to intractable treatment barriers. This project will lead to a technologically-based alcohol treatment system that can circumvent many of these barriers to treatment as well as provide interventions where they are needed most, namely, in real-world, high-risk environments. This treatment system holds the potential to revolutionize alcohol addiction treatment and to extend services to millions of individuals who otherwise would not obtain needed treatment.